Types of Therapy for Eating Disorders and How They Work

Successfully treating eating disorders usually involves a variety of treatment methods. This can include a combination of therapy, medication, and education. There are several specific types of therapies that can be used for treating eating disorders. What types are used will depend on the eating disorder a person has and each person’s specific needs and goals. Eating disorder treatment centers will usually offer a variety of therapies for their patients. The following are several types of the most prominent therapies used to treat eating disorders.

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (CBT) has been successful in treating several different conditions and is often used for eating disorder recovery. In simplest terms, CBT can be understood as a type of talk therapy. This type of therapy is often used because it can help people quickly identify and learn to cope with challenges in their lives. CBT is sometimes combined with other types of therapies and medications. According to the American Psychological Association, there are several basic principles involved in CBT.

  • Problems or conditions are based, at least in part, on unhelpful or negative thinking patterns. Identifying and sharing thoughts about an individual’s problems is a major part of CBT.
  • Problems or conditions are based, at least in part, on patterns of negative behavior. It’s necessary to reshape ways of thinking that will eventually change behavior.
  • CBT provides better ways of thinking, and ultimately of coping. This can lead to the successful treatment of everything from depression and anxiety to a variety of eating disorders.

There are several strategies CBT will use to help individuals change their thinking patterns and ultimately their behavior. A few of these include using problem-solving skills to deal with difficult situations, developing greater confidence, and using one’s mind to calm and relax the body. CBT therapy also helps individuals understand the motivation and behavior of other people as well. The health professional will work with individuals to help them discover ways to treat their condition that is catered to their specific needs. There are generally no risks involved in CBT. An individual, however, may feel vulnerable or uncomfortable at times. A highly trained therapist can provide psychologically gentle care while helping a person change thinking and behavior patterns.

Cognitive Processing Therapy

Cognitive Processing Therapy (CPT) is a type of therapy that focuses on traumatic events in a person’s life and how that individual copes after experiencing such an event. CPT is often used in the treatment of Post-Traumatic Stress Disorder (PTSD). The National Institutes of Health states that PTSD and eating disorders share similar features that include dissociation, impulsive behavior, and cognitive disturbances. According to the Center for Deployment Psychology, CPT includes several phases of treatment.

  • First Phase – This phase involves an initial assessment to determine the appropriateness of this type of treatment. This may or may not be the best approach for a person with an eating disorder.
  • Second Phase – The second step focuses on psychoeducation, with the therapist and the client working together as a team. A person will learn about their symptoms and how treatment can help.
  • Third Phase – This part of CPT includes allowing the traumatic emotions to come forth while identifying specific thoughts that are hindering recovery. Individuals will be asked to discuss, or possibly write about, the traumatic event that they went through.
  • Fourth Phase – Inaccurate thoughts or beliefs are referred to as “stuck points.” These stuck points are then identified and worked out through open-ended questioning. The stuck points are then connected to trauma themes that may include issues regarding safety, intimacy, trust, and self-esteem. The patient takes a very active role during this part of therapy.
  • Fifth Phase – The final stage of therapy involves reviewing what has occurred so far during therapy, making plans for the future, and focusing on relapse prevention.

CPT generally is completed in 12 sessions and takes approximately 3 months to complete. The actual sessions are usually very structured. Individual sessions are approximately 50 minutes in length while group sessions will be 90 to 120 minutes long. CPT is a type of therapy that is used at many eating disorder treatment centers.

Dialectical Behavioral Therapy

This type of therapy is a modified form of CBT that emphasizes both psychological and social factors. Dialectical Behavioral Therapy (DBT) builds on the principles practiced in CBT. DBT focuses on how some people’s emotions will be aroused much quicker than other’s and that their emotional reactions will be much stronger. There are four specific areas of emphasis in DBT.

  • Mindfulness – Observation, description, and participation are all aspects of mindfulness. St. Catherine University describes mindfulness strategies as purposeful observation, paced breathing, and self-soothing.
  • Interpersonal Effectiveness – This part of therapy emphasizes personal relationships and interactions with other people.
  • Distress Tolerance – This is a unique approach to stress in that it focuses on accepting and learning to tolerate stressful situations.
  • Emotion Regulation – Identifying and controlling emotions is a key component of DBT.

Dialectical Behavioral Therapy is different from other types of therapy in another significant way. DBT usually requires both individual and group therapy on a weekly basis. During group therapy, individuals will learn skills from one of the following methods: distress tolerance, interpersonal effectiveness, mindfulness skills, and emotion regulation. Group therapy provides a supportive and safe environment to practice these types of skills. DBT is increasingly being used for eating disorder treatment.

Interpersonal Psychotherapy

Interpersonal Psychotherapy works on improving relationships and significant social roles in a person’s life. The person works with a therapist to target problems in the individual’s life such as significant life changes or conflicts with other people. This type of eating disorder counseling may be used to treat eating disorders since difficult relationships or significant changes may be the underlying cause of the problem. The primary goal of interpersonal therapy is to improve current relationships in a person’s life. There are several specific ways that this can be accomplished.

  • Interpersonal therapy can help an individual make a smooth transition during major life changes and events.
  • This therapeutic approach can help a person work through unresolved grief.
  • It can be used to solve role disputes and general problems in a relationship.

This type of therapy normally will last three or four months. It can last much longer, however, depending on the person’s needs. Interpersonal therapy is considered different than other types of therapy because it specifically focuses on one or two distinct problem areas in a person’s life. This pinpoint focus helps bring about rapid change in these few areas. It can help an individual improve relationships, learn skills for relating to other people, reduce hostile or destructive behaviors, and improve communication. These changes, in turn, help a person successfully recover from an eating disorder.

Acceptance and Commitment Therapy

Acceptance and Commitment Therapy (ACT) stems from CPT and other traditional types of therapy. One of the key components of this type of therapy is for an individual to stop denying and avoiding their inner emotions. People learn to accept that their feelings are, in some circumstances, appropriate responses. The goal is for individuals to accept the difficulties and issues in their lives and then commit to making changes in their current behavior. According to Good Therapy, there are several core processes involved in ACT.

  • Acceptance – This means allowing unpleasant thoughts and experiences to exist without trying to alter or change them.
  • Being Present – This means living in the moment without trying to change the experience or predict what will happen next.
  • Self as Context – This means that people can find themselves outside of the current experience.
  • Values – Individuals will try to work toward and live out the values that are important to them.
  • Committed Action – The person will commit to living their values on a daily basis.

Being able to relate to different events and ideas is a primary concept in Acceptance and Commitment Therapy. This type of therapy is used to treat anxiety as well as eating disorders.

Nutritional Therapy

Understanding nutrition is obviously an important aspect of treating an eating disorder. Nutritional therapy is often used in conjunction with other types of psychotherapy. Registered Dietitians are professionals that have extensive education and meet licensing requirements in the field of nutrition. These professionals can help individuals establish a new relationship with food. A dietitian can teach people how to understand hunger and fullness in ways that will enable them to develop successful eating habits. The National Eating Disorders Association (NEDA) states that treatment goals for both Anorexia Nervosa and Bulimia Nervosa include developing a neutral relationship with food.

There are also physical goals that registered dietitians can help people meet. These could include establishing correct blood-sugar levels and regulating blood phosphate levels. Nutritional therapy plays a crucial role from the very beginning of treatment and throughout the recovery process. Dietary recommendations can help initiate a positive relationship with food both physically and psychologically. A dietitian can also help people establish an eating routine they can successfully follow for the rest of their lives. When looking for eating disorder treatment centers, it’s important to find one that provides adequate nutritional counseling.

Family Therapy

Incorporating family members into therapy can help individuals identify problems that are hindering their progress and encourage the entire family to work together to solve those problems. While this is especially true for adolescents working toward becoming fully recovered, family therapy can help people of all ages. According to the National Institutes of Health, family therapy is particularly helpful for adolescents that have Anorexia Nervosa. Family therapy can help an individual deal with family conflicts that may be a contributing factor in an eating disorder.

There are several different approaches a therapist can take when bringing the entire family into therapy. The family works together as a unit to help the individual cope with upcoming life events or challenges. Some methods have included the family actually bringing a meal into therapy so the therapist can observe and instruct the family. Since family members are often the most important individuals in a person’s life, this can be a very effective type of eating disorder counseling. Family issues are often at the root or contribute to a variety of eating disorders.

Expressive Arts Therapy

Expressive Arts Therapy combines creative arts and psychology therapy to promote healing and growth. The type of creative arts that are incorporated into the therapy process can include music, dance, theater, or even poetry. These are just a few of the artistic forms that can be used for eating disorder treatment. A therapist will observe an individual’s impulses during the time of artistic expression.

Throughout the therapy process, individuals may express themselves through storytelling, poetry, or other art forms. The therapy is not necessarily based on the final result, but on the creative process itself. Artistic expression is used to bring forth and understand inner feelings. The theory is that since art comes from an emotional place inside of individuals this is a creative way to bring out emotions that may be hindering or detrimental to a person’s success in life. Creativity becomes the path to understanding and self-discovery.

The eating disorder recovery process should be customized to meet each individual’s personal needs. Before deciding which type of therapy or a combination of therapy is the best treatment option, individuals will need to find the best treatment center to meet their needs. Oliver-Pyatt Centers provide extensive psychiatric and medical care for their patients. This includes a variety of therapies. Wendy Oliver-Pyatt states, “Whether you are mentally or physically exhausted from your eating disorder, or not yet ready to let go, there is the possibility for change and personal growth in your life.” Contact Oliver-Pyatt Centers today to learn more about these exciting possibilities.